Pharmacokinetics, effectiveness and mid-term outcomes of very early caffeine citrate in extremely preterm infants

Research summary

Preterm birth (< 37 weeks of gestation) is a significant cause of childhood morbidity and mortality, as it is estimated that one million children worldwide die each year of complications of prematurity. Therefore, prevention of morbidities related to preterm birth is considered a central health priority. Two thirds of extremely preterm infants (< 29 weeks of GA) will need intubation and mechanical ventilation (MV) due to lack of surfactant and lack of respiratory drive. Lack of respiratory drive is manifested in the form of apnoea that can lead to intubation and MV. Methylxanthines, in particular caffeine, have been used to help treat apnoea of prematurity in very preterm infants. At the moment, there is no sufficient data on caffeine metabolism and excretion in extremely preterm babies in the first week of life. Subsequently, Despite the well-known role of caffeine as a drug of choice for the treatment of apnea of prematurity, there are currently no commonly agreed, standardized protocols on its administration, and its very early use in preterm infants is limited. We aim to measure the caffeine blood levels during the first week of life in 50 preterm babies, born between 23+0 and 29+0 weeks of gestation. The caffeine level samples will be in addition to the clinically indicated blood tests. This is an observational study, aiming to define pharmacokinetics of caffeine in preterm babies, to identify the optimal timing and dose to stimulate respiratory drive, avoid apnea and mechanical ventilation.

Principal Investigator

Dr Amit Gupta

Contact us

Email: neonatal.research@ouh.nhs.uk

IRAS number

253247